Infectious complications after allogeneic stem cell transplantation:: epidemiology and interventional therapy strategies -: Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)

被引:56
作者
Einsele, H
Bertz, H
Beyer, J
Kiehl, MG
Runde, V
Kolb, HJ
Holler, E
Beck, R
Schwerdfeger, R
Schumacher, U
Hebart, H
Martin, H
Kienast, J
Ullmann, AJ
Maschmeyer, G
Krüger, W
Niederwieser, D
Link, H
Schmidt, CA
Oettle, H
Klingebiel, T
机构
[1] Univ Tubingen, Med Clin 2, Dept Hematol Oncol, D-72076 Tubingen, Germany
[2] Univ Freiburg, Dept Hematol & Oncol, Freiburg, Germany
[3] Univ Marburg, Dept Hematol & Oncol, Marburg, Germany
[4] Clin BMT Hematol & Oncol, Idar Oberstein, Germany
[5] Univ Essen Gesamthsch, Clin & Policlin BMT, Essen, Germany
[6] Hosp Complex Grosshadern, Med Univ Clin 3, Munich, Germany
[7] BMT Ctr, German Clin Diagnost, Wiesbaden, Germany
[8] Univ Frankfurt, Ctr Internal Med, Dept Hematol, D-6000 Frankfurt, Germany
[9] Univ Munster, Dept Hematol Oncol, D-4400 Munster, Germany
[10] Univ Mainz, Dept Med 3, D-6500 Mainz, Germany
[11] Humboldt Univ, Dept Internal Med Hematol & Oncol, Campus Virchow Klinikum, Charite Univ Hosp, Berlin, Germany
[12] Univ Halle Wittenberg, Dept Internal Med 4, Halle Saale, Germany
[13] Univ Hosp Leipzig, Leipzig, Germany
[14] Hosp Complex Westpfalz, Med Clin 1, Kaiserslautern, Germany
[15] Univ Clin, Frankfurt, Germany
关键词
bone marrow transplantation; stem cell transplantation; infections; epidemiology; treatment;
D O I
10.1007/s00277-003-0772-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The risk of infection after allogeneic stem cell transplantation is determined by the underlying disease, the intensity of previous treatments and complications that may have occurred during that time, but above all, the risk of infection is determined by the selected transplantation modality (e.g. HLA-match between the stem cell donor and recipient, T cell depletion of the graft, and others). In comparison with patients treated with high-dose chemotherapy and autologous stem cell transplantation, patients undergoing allogeneic stem cell transplantation are at a much higher risk of infection even after hematopoietic reconstitution, due to the delayed recovery of T and B cell functions. The rate at which immune function recovers after hematopoietic reconstitution greatly influences the incidence and type of post-transplant infectious complications. Infection-associated mortality, for example, is significantly higher following engraftment than during the short neutropenic period that immediately follows transplantation.
引用
收藏
页码:S175 / S185
页数:11
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